Landis, Gregory C

Landis, Gregory C is an individual health care provider with primary practice located at 3201 5Th St , Lewiston ID 83501. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Landis, Gregory C can be contacted via phone (208) 743-2020.

Contact Information

Primary practice address
3201 5Th St Lewiston ID 83501
Phone: (208) 743-2020
Fax: (087) 433-5832
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3948/T1027 Ohio
Eye and Vision Services Providers / Optometrist 152W00000X ODP-100426 Idaho

Profile Details

NPI number 1447253885
LBN Legal business name Landis, Gregory C
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated May 23rd, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447253885 NPPES
Ohio Other 000000117385 ANTHEM BC/BS
Ohio Other 2201051 ANTHEM BC/BS
Ohio Other 5886015 ANTHEM BC/BS
Ohio MEDICAID 0729082 ANTHEM BC/BS

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